{"title":"肺静脉分离伴或不伴用新型冷冻球囊消融左心房后胃动力低下。","authors":"Atsuhito Oda, Takatoshi Shigeta, Yuichiro Sagawa, Kazuya Murata, Hirofumi Arai, Yumi Yasui, Yuichi Fukami, Kaoru Okishige, Manabu Kurabayashi, Tetsuo Sasano, Yasuteru Yamauchi","doi":"10.1111/pace.15204","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The novel POLARx cryoballoon ablation (CBA) system offers enhanced cooling properties for the treatment of atrial fibrillation (AF); however, these capabilities may damage adjacent tissues. This study aimed to assess the prevalence and predictors of gastric hypomotility (GH) in patients undergoing pulmonary vein isolation (PVI) and left atrial (LA) roofline ablation using the POLARx.</p><p><strong>Methods: </strong>Patients who underwent CBA for PVI using the POLARx system were included in this study. Additional LA roofline ablation was performed in patients with non-paroxysmal AF and paroxysmal AF with LA enlargement. GH occurrence was assessed postoperatively by esophagogastroscopy, and the distance between the esophagus and surrounding tissues were measured.</p><p><strong>Results: </strong>Among the 61 patients who underwent PVI, 22 underwent additional LA roofline ablation. GH was confirmed in 12 patients (30.8%) who underwent PVI only and 12 patients (54.5%) who underwent additional LA roofline ablation. Symptomatic GH with acute gastric dilation occurred in three patients, all of whom had undergone roofline ablation. Multivariate analysis, a shorter distance between the esophagus and the midpoint of the vertebral body (odds ratio, 0.74; 95% confidence interval, 0.55-0.98; p = 0.04) was identified as the sole predictor of GH, with a cutoff of 20.0 mm (sensitivity, 80.0%; specificity, 81.8%).</p><p><strong>Conclusion: </strong>Adding LA roofline ablation to PVI using the POLARx may increase the risk of GH, particularly when the esophagus is in close proximity to the midpoint of the vertebral body.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Gastric Hypomotility After Pulmonary Vein Isolation With or Without Left Atrial Roof Ablation Using a Novel Cryoballoon.\",\"authors\":\"Atsuhito Oda, Takatoshi Shigeta, Yuichiro Sagawa, Kazuya Murata, Hirofumi Arai, Yumi Yasui, Yuichi Fukami, Kaoru Okishige, Manabu Kurabayashi, Tetsuo Sasano, Yasuteru Yamauchi\",\"doi\":\"10.1111/pace.15204\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The novel POLARx cryoballoon ablation (CBA) system offers enhanced cooling properties for the treatment of atrial fibrillation (AF); however, these capabilities may damage adjacent tissues. This study aimed to assess the prevalence and predictors of gastric hypomotility (GH) in patients undergoing pulmonary vein isolation (PVI) and left atrial (LA) roofline ablation using the POLARx.</p><p><strong>Methods: </strong>Patients who underwent CBA for PVI using the POLARx system were included in this study. Additional LA roofline ablation was performed in patients with non-paroxysmal AF and paroxysmal AF with LA enlargement. GH occurrence was assessed postoperatively by esophagogastroscopy, and the distance between the esophagus and surrounding tissues were measured.</p><p><strong>Results: </strong>Among the 61 patients who underwent PVI, 22 underwent additional LA roofline ablation. GH was confirmed in 12 patients (30.8%) who underwent PVI only and 12 patients (54.5%) who underwent additional LA roofline ablation. Symptomatic GH with acute gastric dilation occurred in three patients, all of whom had undergone roofline ablation. Multivariate analysis, a shorter distance between the esophagus and the midpoint of the vertebral body (odds ratio, 0.74; 95% confidence interval, 0.55-0.98; p = 0.04) was identified as the sole predictor of GH, with a cutoff of 20.0 mm (sensitivity, 80.0%; specificity, 81.8%).</p><p><strong>Conclusion: </strong>Adding LA roofline ablation to PVI using the POLARx may increase the risk of GH, particularly when the esophagus is in close proximity to the midpoint of the vertebral body.</p>\",\"PeriodicalId\":54653,\"journal\":{\"name\":\"Pace-Pacing and Clinical Electrophysiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-05-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pace-Pacing and Clinical Electrophysiology\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1111/pace.15204\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pace-Pacing and Clinical Electrophysiology","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1111/pace.15204","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Gastric Hypomotility After Pulmonary Vein Isolation With or Without Left Atrial Roof Ablation Using a Novel Cryoballoon.
Background: The novel POLARx cryoballoon ablation (CBA) system offers enhanced cooling properties for the treatment of atrial fibrillation (AF); however, these capabilities may damage adjacent tissues. This study aimed to assess the prevalence and predictors of gastric hypomotility (GH) in patients undergoing pulmonary vein isolation (PVI) and left atrial (LA) roofline ablation using the POLARx.
Methods: Patients who underwent CBA for PVI using the POLARx system were included in this study. Additional LA roofline ablation was performed in patients with non-paroxysmal AF and paroxysmal AF with LA enlargement. GH occurrence was assessed postoperatively by esophagogastroscopy, and the distance between the esophagus and surrounding tissues were measured.
Results: Among the 61 patients who underwent PVI, 22 underwent additional LA roofline ablation. GH was confirmed in 12 patients (30.8%) who underwent PVI only and 12 patients (54.5%) who underwent additional LA roofline ablation. Symptomatic GH with acute gastric dilation occurred in three patients, all of whom had undergone roofline ablation. Multivariate analysis, a shorter distance between the esophagus and the midpoint of the vertebral body (odds ratio, 0.74; 95% confidence interval, 0.55-0.98; p = 0.04) was identified as the sole predictor of GH, with a cutoff of 20.0 mm (sensitivity, 80.0%; specificity, 81.8%).
Conclusion: Adding LA roofline ablation to PVI using the POLARx may increase the risk of GH, particularly when the esophagus is in close proximity to the midpoint of the vertebral body.
期刊介绍:
Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.